At least 196 humanitarian workers have been killed in Gaza since October, according to the United Nations, which is calling on the Israeli government to allow aid agencies to "do their job".
This comes after seven World Central Kitchen (WCK) workers, including Australian Lalzawmi "Zomi" Frankcom, were killed when an Israeli air strike hit their convoy.
Israel Defense Forces (IDF) Chief of Staff Herzi Halevi said the strike was "not carried out with the intention of harming WCK aid workers".
"It was a mistake that followed a misidentification — at night, during a war, in very complex conditions. It shouldn't have happened," he said.
The deadly strike has caused agencies to pause their operations in Gaza.
Here's a closer look at how agencies operate in war zones, and the measures in place to protect workers.
Agencies give detailed information to Israeli government
Derek Madsen is the chief development officer of Anera (American Near East Refugee Aid) which has operated in Gaza for 55 years and has delivered more than 22 million meals during this current conflict in coordination with agencies, including WCK.
He said aid agencies provided "very detailed information" to the Israeli government about their transit, location and aid efforts.
"We're speaking to Israeli agencies in anticipation of aid being delivered," he said.
"When it comes in, it's inspected extensively and then there's information about how it is delivered. There is a lot of coordination."
He said given the time and effort that goes into providing the information it was "disconcerting" that workers continued to die.
"I can't speak to how the government is using this information, but it gives us significant pause about the effectiveness of these processes when we spend so much time providing such great detail and tragedies … continue to befall," he said.
In March, Mousa Shawwa, who was a Palestinian aid worker employed by Anera, died in a strike on his shelter.
Mr Madsen said the agency had provided updated coordinates on his location four days before his death.
WCK said its team which was killed was travelling in a "deconflicted zone" in two armoured cars branded with its logo and their movements had been coordinated with the IDF.
Mr Madsen said it was concerning that people were dying despite the correct procedures being followed.
"This is a distressing pattern and one that we work hard to avoid by providing detailed information so we can attempt to prevent it."
Forced to deliver on an 'opportunistic basis'
The UN has complained about the obstacles to getting aid in and distributing it.
UN spokesperson Stéphane Dujarric said they had noted that the "deconfliction" mechanism it was using was "not working properly".
Deconfliction mechanisms are used by aid organisations in conflict zones to communicate information, including the coordinates of their convoys, warehouses and guest houses with local authorities.
"We have noted it was not working properly. We keep delivering aid … on an opportunistic basis, which is no way to run a major aid operation," Mr Dujarric said.
UN humanitarian coordinator Jamie McGoldrick said they had people in "very dangerous situations" without the ability to communicate between the different groups and teams.
"Israel says we shouldn't have communication equipment because if we do it could be taken by Hamas and used by Hamas," he said. "I think it is a poor excuse."
Displaced locals relied on in Gaza
Oxfam Australia is working in partnership with a number of local organisations to ensure people in Gaza have access to food, safe water and sanitation services.
Oxfam Australia's head of humanitarian Lucia Goldsmith said they rely on Gaza residents to deliver the vast majority of aid once it has crossed the border.
She said their ability to move around was essential to helping people in need.
"That's incredibly difficult in a situation where these people have been themselves often displaced multiple times and they're struggling to provide for their families to ensure that they have access to food and other essential services," she said.
Ms Goldsmith said while the death of the seven international workers had seen increased media coverage and caused global leaders to speak out, close to 200 locals providing humanitarian aid had been killed since October.
"The only way to ensure that aid can be delivered safely is if there is a permanent ceasefire in place," she said.
What laws protect humanitarian workers in conflict zones?
University of Sydney's Ben Saul, who is also a UN rapporteur on human rights, said under international humanitarian law there was always an obligation on all of the parties to respect and protect humanitarian personnel.
"That means you shouldn't deliberately, or indiscriminately or recklessly attack humanitarian personnel, or humanitarian objects, the relief that they're delivering."
Professor Saul said, like civilians, humanitarian workers deserved special protection under the law of war.
"But because they're humanitarian workers, they also get an extra layer of protection as well," he said.
However, Mr Madsen has questioned the effectiveness of the laws.
"I'm hopeful that we can return to a place where aid workers can expect that that will be honoured in a way that allows us to do our work."
Professor Saul said Australia could take action if it was not satisfied with the investigation that was being conducted by Israel.
"If Australia is not satisfied with the thoroughness, independence and impartiality of the Israeli investigation, of course, Australia would be entirely within its rights to respond with sanctions on Israel," he said.
Agencies pausing operations after Israeli strike
Following the deadly strike, WCK announced it was pausing its operations in Gaza.
Mr Madsen's organisation Anera has also paused its operations after staff on the ground raised concerns for their safety.
"Currently, our staff feel that they can no longer safely do this given the consistent escalated nature of the strikes against humanitarian aid workers," he said.
"We've decided to temporarily pause that until such time that they feel they can safely conduct that work."
Ms Goldsmith said while safety was a top priority other constraints also hampered the delivery of aid.
This includes the difficulty in moving around on account of the number of roads being destroyed and "arbitrary decisions" being made on the type of aid that can cross the border into Gaza.
"Aid agencies are experiencing significant restrictions on visas and work permits that are not being issued to international staff, which further limits our ability to bring in international personnel to support our colleagues," she said.
ABC/ Wires
